PENGARUH LATIHAN PASRAH DIRI TERHADAP KUALITAS TIDUR (Studi Pada Pasien Gagal Ginjal Kronis Dengan Simtom Depresi Yang Menjalani Hemodialisis Rutin)

dr. Wuryanto, dr. Agus Siswanto, SpPD KPsi,

2012 | Tesis | S2 Ked.Klinik/MS-PPDS

Penderita gagal ginjal kronik (GGK) mengalami berbagai macam stresor fisik, psikis maupun sosial sehingga rentan terhadap munculnya simtom depresi. Simtom depresi dan berbagai kondisi yang terkait GGK dapat menyebabkan terjadinya gangguan kualitas tidur. Latihan pasrah diri (LPD) merupakan bagian dari Complementary and Alternative Medicine (CAM) dalam penatalaksanaan simtom depresi yang memadukan relaksasi dan dzikir dengan fokus latihan pada pernafasan dan kata yang terkandung didalam dzikir (relaxation and repetitive prayer) untuk membangkitkan respons relaksasi, sehingga diharapkan mampu memperbaiki simtom depresi dan kualitas tidur. Tujuan penelitian ini untuk mengetahui pengaruh LPD terhadap perbaikan simtom depresi dan kualitas tidur pada penderita gagal ginjal kronik dengan simtom depresi. Penelitian menggunakan metode Randomized Controlled Trial (RCT) yang dilakukan di Instalasi Hemodialisis RSUP Dr. Sardjito antara bulan Mei 2012. Distribusi atau sebaran data diuji menggunakan uji statistik Kolmogorov- Smirnov (Shapiro-Wilk). Perbedaan skor rerata BDI dan skor PSQI masingmasing kelompok dengan uji t untuk kelompok berpasangan jika distribusinya normal atau Wilcoxon test jika distribusi tidak normal. Pengaruh LPD terhadap perbedaan skor rerata BDI dan skor PSQI kelompok perlakuan dibanding kontrol diuji dengan independent t-test. Perbedaan dianggap bermakna bila nilai p < 0,05 dengan interval kepercayaan 95 %. Hasil penelitian menyajikan karakteristik subyek berdasarkan umur, jenis kelamin, tingkat pendidikan, pekerjaan, status merokok, IMT, penyakit komorbid, terapi, profil lipid, kadar ureum dan kreatinin, hemoglobin, fungsi hati, skor BDI dan skor PSQI. Penelitian ini akan menunjukkan manfaat LPD terhadap perbaikan simtom depresi dan kualitas tidur penderita GGK.

Patients with chronic renal failure (CRF) had both of physical, psychological and social stressors, so vulnerable to the emergence of depression symptoms. Symptoms of depression and other CRF conditions related to CRF lead to disturbances in sleep quality. “Latihan Pasrah Diri (LPD)” is a part of the Complementary and Alternative Medicine (CAM) in the management strategies of depression symptoms that combines relaxation and “dhzikr’ (repetitive prayer) focusing on breathing and the words contained in the “dhzikr’ to evoke the relaxation response, which expected to improve the depression symptoms. This study was conduct to determine the effect of LPD on the improvement of symptoms of depression and sleep quality in patients with chronic renal failure with symptoms of depression. A Randomized Placebo Controlled Trial (RCT) design was conducted in the Hemodialysis Unit of Dr. Sardjito hospital in May to June 2012. Data distribution was tested using Kolmogorov-Smirnov (Shapiro-Wilk) statistical test. The Beck Depression Inventory (BDI) mean score and PSQI score of each group was tested by t-test for paired group if the distribution of data was normal or Wilcoxon test if the distribution was not normal. Effect of LPD on BDI mean score and PSQI score of the treatment and control groups were tested using independent t-test. The differences were significant if p value < 0.05 with 95% confidence of interval. The results of this study presented the characteristics of subjects by age, sex, educational level, occupation, smoking status, BMI, comorbids, therapy, lipid profile, blood urea and creatinine, hemoglobin, liver function, BDI score and the PSQI score. This research will demonstrate the benefits of LPD on the improvement of depression symptoms and sleep quality in patients with chronic renal failure.

Kata Kunci : GGK, LPD, simtom depresi, kualitas tidur